Call for feedback: WASHwatch reports back from workshop on monitoring the human right to water and sanitation

WASHwatch recently attended a two day workshop on monitoring the human right to water and sanitation (HRWS). The event was hosted by WaterLex in partnership with the Danish Institute for Human Rights and the Stockholm International Water Institute.

The workshop brought together WASH legal specialists, WASH advocates and human rights practitioners. Unfortunately, attendance from people with technical WASH perspectives seemed lacking (most likely due to exciting World Toilet Day events taking place the same week). Hopefully this report will help engage you in the issues of monitoring the HRWS. We welcome responses to this post, and more specifically, your feedback on proposed HRWS indicators.

What needs to be monitored?

The HRWS requires access to water and sanitation to be sufficient, safe, acceptable, physically accessible and affordable (see UN General Assembly Resolution A/HRC/RES/27/7).

In the delivery of human rights, states must uphold principles of non-discrimination, equality, transparency, public participation, access to remedy / accountability measures, sustainability and non-retrogression (see Principles Handbook on Realising the HRWS).

Monitoring progress is essential to encouraging the protection and implementation of human rights. Monitoring increases transparency, informs policy and programming, and holds states accountable for progressively realising the HRWS in line with legal obligations.

The WASH MDG targets (MDG 7c) and associated monitoring tools used by the JMP (i.e. household surveys) fail to capture several important elements of human rights principles and standards of the recently recognised HRWS (see UN General Assembly Resolution A/64/292). There are currently several opportunities to collaboratively refine global water and sanitation monitoring mechanisms. The United Nations Office of the High Commissioner for Human Rights (UN OHCHR) is presently working on developing HRWS indicators, which will guide states in monitoring. Additionally, the process of developing post-2015 Sustainable Development Goals (SDGs) is underway. The SDGs will play a prominent role in state level WASH planning and monitoring. A key challenge for our sector is ensuring that the monitoring of the SDGs and the HRWS is mutually supportive, and that all global monitoring supports and incentivises high quality national level sector management.

How are human rights monitored?

The workshop focused on HRWS monitoring proposals from UN OHCHR, and therefore followed a human rights-based approach to monitoring. Rights-based approaches to monitoring include structural, process and outcome indicators.

Structural indicators are meant to identify whether or not states have the policies and regulations required to provide an enabling environment for the realisation of the HRWS.

Process indicators, which seek to monitor states’ methods of delivering water and sanitation services with consideration to human rights principles (i.e., non-discrimination, participation, etc.), are vital to understanding the extent of the application of rights-based approaches to water and sanitation delivery.

Lastly, outcome indicators measurements of actual access to water and sanitation within defined standards (i.e., safe, affordable, sufficient, etc.), are necessary to monitor true experiences of the HRWS within states.

The full set of indicators proposed by UN OHCHR for monitoring the HRWS can be found here.

How should the human right to water and sanitation be monitored?

Presentation of these proposed indicators prompted much discussion among the workshop delegates. Delegates focused discussions primarily around two questions.

  1. Are process indicators fit for purpose?

Translating policy, regulation, and planning into outcomes is often seen as a “black box” of unknowns, since process indicators are among the most challenging to develop and measure with accuracy.

While proposed process indicators are meant to be proxies for human rights principles, there was a general consensus among delegates that many seemed more reflective of outcome indicators. For example, delegates felt the following indicator was an outcome indicator, rather than a process indicator: “Proportion of schools and institutions with separate sanitation facilities for men or women and boys or girls with menstrual hygiene management.”

Delegates felt improvements could be made with the inclusion of more indicators concerned with how services are delivered, rather than the expected outcome of if services are delivered in consideration of a human rights principle. An example of reframing the above proposed indicator to capture whether or not services are delivered in consideration of gender could be: “proportion of schools and institutions serviced with new facilities that provide access to separate sanitation facilities for men or women and boys or girls with menstrual hygiene management.”

  1. Should the right to water and sanitation be separated?

The combined presentation of the HRWS increases complexities associated with planning, delivering and monitoring the right. However, under current international law, water and sanitation remain as one human right.

At the close of the workshop, Prof Eibe Riedel spoke of consolidating workshop proceedings for publication. This, coupled with the on-going UN OHCHR and SDG processes, present opportunities for the WASHwatch community to contribute to an important debate that will surely impact future WASH policy and program development.

We are therefore seeking your comments and feedback on the proposed set of UN OHCHR indicators. When reviewing the proposals, keep in mind that indicators need to be manageable, feasible in practice, and cross cutting where possible.

Please send any feedback on proposed indicators to – We will publish your contributions on and collate all responses for submission to Prof Eibe Riedel, UN OHCHR, and End Water Poverty (who are engaged in SDG advocacy) for consideration.


Water and Sanitation Report Card: Slow Progress, Inadequate Funding


The Ebola crisis has thrown into sharp relief the issue of water, sanitation and hygiene in treating and caring for the sick. Dying patients are being taken to hospitals which never had enough water to maintain hygiene, and the epidemic has pushed the system to the breaking point.

Last week’s World Health Organisation report produced by UN Water, the Global Analysis and Assessment of Sanitation and Drinking Water (GLAAS), has provided a sobering picture of water and sanitation services so necessary to healthcare systems around the world.

The annual analysis is a gold mine of data, covering 94 countries and using information from 23 aid agencies. The story it tells this year is of modest progress alongside inadequate funding, poor monitoring and a desperate need for skilled regulators, administrators and engineers to keep services running effectively.

Among GLAAS’s most important findings are how poorly finances intended to address the water and sanitation crisis are targeted.

Urban areas are prioritised over rural regardless of the level of need – nearly three-quarters of aid spending goes to urban areas and more than 60 percent of aid is in the form of loans, which are rarely targeted to the poor. This suggests rural people and the urban poor are being further marginalised.

Nearly three-quarters of the aid targeted at water, sanitation and hygiene programmes is spend on drinking water supplies. Despite these investments in improved supplies, 1.8 billion people drink water contaminated with fecal matter.

It’s fair to assume that this is linked to the 2.5 billion people still without a basic toilet. Too much money is being invested in finding or making clean water, and not enough in containing the waste that contaminates it.

Addressing these issues effectively requires money, training and monitoring, but these, too, are falling short.

The GLAAS report has found that financing for water and sanitation in 70 percent of responding countries covers less than 80 percent of the costs of operation and maintenance for existing services.

Regulators, administrators and engineers are all in short supply in developing countries. All are of critical importance in the safe, sustainable delivery of water and basic sanitation services, fundamental to good public health and economic growth. Yet it’s rare to see plans or investment to address this. Only one third of countries even have a human resources strategy in place.

Monitoring is also seriously lacking. WaterAid is examining the sanitation transformations that took place in East Asia, and has found that responsive monitoring which actually leads to changes in policy and investment is a crucial driver of sanitation improvements. But very few countries have enough personnel to collect or review data, or enough senior political interest to demand it.

Less than half of countries have a formal rural service provider that reports to a regulatory authority, and effectively monitors its services.

What does this mean? It means that half of the lucky minority of rural poor who have gained access to improved water and sanitation are still using unregulated services which have no way to guarantee safety.

But there is progress. Proposals for the U.N.’s new Sustainable Development Goals, now under negotiation, include goals for water and sanitation services that include schools and healthcare facilities along with households.

This is of huge importance, particularly when we look at the Ebola crisis in West Africa – where healthcare systems in Liberia and Sierra Leone in particular were broken in years of conflict and never properly rebuilt – or this year’s cholera outbreak in Ghana, where 20,900 people were infected and 166 died of preventable infection transmitted by water contaminated with human waste.

The GLAAS reports that less than one-third of countries have a plan for drinking water or sanitation in health care facilities and schools that is implemented, funded and reviewed regularly. These targets are long overdue.

The state of water and sanitation is a global health crisis. Some 10 million children have died since 2000 of diarrhoeal illnesses, directly linked to growing up without clean water, basic toilets and hygiene. It is possible to reach everyone, everywhere with water, sanitation and hygiene education, but it will require strong political will, a comprehensive and accelerated approach, and financing.

As the U.N. negotiates the new Sustainable Development Goals, including a strong, dedicated goal on water and sanitation that incorporates water and sanitation targets into goals on healthcare will address many of these shortfalls.

What the present shortlist does not include, but which the GLAAS report has clearly shown, is the need to find and train people to drive this transformation, and keep services running sustainably.

This article was originally published on Inter Press Service News Agency on November 24, 2014. Analysis by Tim Brewer.


Aligning Voices for Improved WASH sector Monitoring: A Reflection on the European WASH & NTD Roundtable

Last week, I had the opportunity to attend the European WASH and NTDs Roundtable hosted by SHARE Research Consortium. The event brought together academics, donors and NGOs, with the aim of significantly progressing collaboration, coordination, and cooperation between the water, sanitation and hygiene (WASH) and neglected tropical diseases (NTDs) sectors. The roundtable focused on the areas of mapping, data collection, monitoring, and research.

Although sometimes overlooked, the WASH and NTDs sectors are greatly interconnected. Half of all NTDs, which result in malnutrition, child stunting, impaired cognitive function, disability, and even death, are related to WASH. Access to safe WASH plays an important role in breaking NTDs transmission cycles and preventing disease. Additionally, improved WASH is required for NTDs wound and disability management – without it, individuals infected with disease are left even more vulnerable. Collaboration between WASH and NTDs sectors is clearly important and mutually beneficial.

Day 1 of the roundtable focused on developing joint sector measures and indicators for monitoring. This is a clear topic of interest to, which aims to strengthen WASH sector transparency and monitoring for improved accountability.

Participants worked in small groups to focus on developing joint indicators for either water and NTDs, sanitation and NTDs, or hygiene and NTDs. Discussions in groups focusing on sanitation or water and NTDs similarly centred on reflecting on current monitoring mechanisms; identifying gaps, and finding solutions for how to better use existing data for joint sector monitoring and reporting.

More specifically, participants reflected on the need for WASH monitoring to move beyond access to improved drinking water sources and sanitation facilities in order to adequately reflect both sectors’ interests.

It became clear that water-related indicators would need to consider different uses of water (e.g., for hand washing, bathing, and domestic chores), the quantity of water available for all uses (including hygiene and wound management), and the true quality of water in use (i.e., through water testing rather than assumed quality based on water source type).

In terms of sanitation, participants said that indicators would need to adequately capture vector control measures of sanitation facilities (vectors, such as flies, can be carriers of disease and facilitate transmission), the true environmental protection of facilities (i.e., through soil testing rather than assumed protection based on facility type), and the use of excreta after the point of defecation (e.g., treatment and disposal, or re-use of excreta).

In contrast to sanitation or water and NTDs groups, those focused on hygiene and NTDs put forward specific indicators for collaboration. This could have been expected given the vast gap in current monitoring mechanisms, which exclude hygiene. Joint indicators put forward included:

  • Proportion of people hand washing at key times with soap or ash;
  • Proportion of children with clean faces through proper washing;
  • Proportion of people regularly practicing personal hygiene in non-surface water;
  • Proportion of people who wear appropriate footwear;
  • Proportion of compounds that are clean, i.e., open defecation free; and
  • Proportion of people with sufficient knowledge about hygiene practices.

The roundtable undoubtedly stimulated the development of concrete ideas for progressing joint WASH and NTDs sector indicators. At the close of the roundtable, there was consensus that the NTDs sector was interested in incorporating WASH indicators. However, the level of interest from the WASH sector to incorporate relevant health indicators was generally perceived to be low. So, how can we mobilise the WASH sector to incorporate such indicators?

Perhaps it’s a simple question of sector reflection: why do we do what we do?

It’s not to build latrines, tippy taps and bore holes. It’s to protect dignity, and, largely, health.

If the purpose of our work goes beyond delivery of services to include health promotion, can we hold ourselves accountable if we don’t measure the impacts of WASH on health? Improved sector accountability should be reason enough to support health indicators in monitoring, but in case you need another incentive, consider the wider support (and funds) for WASH we could garner if we were able to measure impact outside of access.

With the Sustainable Development Goal (SDG) process underway, we have the opportunity to secure health indicators in WASH monitoring. Perhaps the opportunity for success lies in consolidating WASH, public health, and human rights messaging.

Health measures for WASH do not need to be indicators of ill health, as distribution and characteristics of disease data already exists. Rather, indicators would need to speak to the impacts of WASH on health risks.

Impacts of WASH on health risks would measure the true environmental and social protection expected to be delivered with WASH. Current monitoring, which assumes protection by existence and use of improved WASH facilities, does not adequately measure these WASH impacts. Reports of failed environmental, social, and thus, health protection of improved WASH services are not uncommon.

Proposed targets and indicators for post-2015 offer welcome improvements, and are well aligned with findings from the roundtable. This presents an opportunity for the public health sector to refine post-2015 indicators to include their interests.

An additional opportunity for collaboration between WASH and health sectors presents in human rights discourse. The human right to water and sanitation, which includes relevant public health messaging such as, sufficient and safe water for domestic uses as well as drinking, and defines sanitation to include safe treatment and disposal, or re-use of excreta, is being heavily lobbied for formal recognition in the SDGs.

Pooling similar voices from WASH, public health, and human rights advocates to align messaging would result in a stronger influence on sector monitoring in the SDG framework. Joining forces for improved monitoring would benefit all political agendas, and only ensure improved sector accountability in the future.

If you haven’t seen our re-launch yet, check out

Follow us on Twitter: @WASHwatch

Reflection Question for Comment:

To include public health and human rights perspectives would the proposed post-2015 WASH indicators need to be altered?
If yes, how? Would they be feasible? If not, why?


New WASH Access Map

This is something I’ve been working on over the last week with colleagues in WaterAid’s campaigns, media and digital teams. Hopefully it’ll be part of the revamped main site soon (more about that soon!)